| 张学娟,吴冬寒,张学政,等.四种常见胃肠道手术后手术部位感染情况及相关危险因素分析[J].安徽医药,2021,25(4):785-788. |
| 四种常见胃肠道手术后手术部位感染情况及相关危险因素分析 |
| Analysis of surgical site infections and related risk factors after four common gastrointestinal surgery |
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| DOI：10.3969/j.issn.1009-6469.2021.04.037 |
| 中文关键词: 消化系统外科手术 手术后并发症 胃肠道 腹腔内感染 外科伤口感染 手术部位感染 危险因素 |
| 英文关键词: Digestive system surgical procedures Postoperative complications Gastrointestinal tract Intraabdominal infections Surgical wound infection Surgical site infection Risk factors |
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| 中文摘要: |
| 目的探讨 4种常见胃肠道手术后手术部位感染(SSI)情况及相关危险因素。方法回顾性分析了 2015年 1月至 2019年 10月期间在三亚市人民医院接受胃肠道手术治疗的 1 248例病人的临床资料，包括结肠手术 555例、胃手术 364例、肠手术 179例、小肠手术 150例。观察病人住院期间 SSI的发生率，并采用多因素 logistic回归分析 SSI发生相关危险因素。结直1 248例胃肠道手术病人中，切口浅部组织感染 96例(7.7%)切口深部组织感染和器官 /腔隙感染 71例(5.7%)总体 SSI发生果率 167例(13.4%)。其中胃手术病人 SSI发生率最低(8.0%)，直肠，手术病人 SSI发生率最高(17.9%)。 4种常见胃，肠手术中 SSI阳性病人手术时间及术中输血、降血糖药物、手术切口 Ⅲ/Ⅳ类比例较 SSI阴性病人升高(P<0.05)。多因素 logistic回归分析结果示，术中输血、手术时间长、手术切口 Ⅲ/Ⅳ类是 3种以上手术类型 SSI发生的共同危险因素(P<0.05)；使用降血糖药物是结肠手术(OR=1.25，P=0.026)、胃手术(OR=1.73，P=0.000)病人 SSI的危险因素；使用类固醇类药物是结肠手术(OR=1.28，P=0.041)病人 SSI的危险因素；使用腹腔镜手术是 4种胃肠道手术病人 SSI的保护因素(P<0.05)。结论术中输血、手术时间长、手术切口 Ⅲ/Ⅳ类是 3种以上胃肠道手术 SSI发生的共同危险因素，腹腔镜手术是 SSI发生的共同保护因素，使用降血糖、类固醇类药物等危险因素在不同类型的手术中有所差异。 |
| 英文摘要: |
| Objective To investigate four common surgical site infections (SSI) and related risk factors after gastrointestinal surgery. Methods The clinical data of 1,248 patients who underwent gastrointestinal surgery in Sanya People's Hospital from January 2015 toOctober 2019 were retrospectively analyzed, including 555 cases of colon surgery, 364 cases of gastric surgery, 179 cases of rectal surgery and 150 cases of small bowel surgery. the incidence of SSI during the hospitalization of patients was observed, and multivariate logistic regression was used to analyze the risk factors of SSI.Results Among 1,248 patients with gastrointestinal surgery, 96 cases(7.7%) of superficial incision tissue infection, 71 cases (5.7%) of deep incision tissue infection and organ / space infection, and an overall SSI incidence of 167 (13.4%). Among them, the incidence of SSI was the lowest in gastric surgery patients (8.0%), and the highest inpatients with rectal surgery (17.9%). The operation time and intraoperative blood transfusion, antidiabetic drugs, and surgical incisionⅢ/Ⅳ ratios of the four common gastrointestinal surgery patients were higher than those of SSI negative patients (P<0.05). MultivariateLogistic regression analysis results showed that intraoperative blood transfusion, long operation time, and surgical incision type Ⅲ/Ⅳwere common risk factors for the occurrence of SSI in more than 3 types of surgery (P<0.05). The use of antidiabetic drugs was a risk factor for SSI in patients undergoing colon surgery (OR=1.25, P=0.026) and gastric surgery (OR=1.73, P=0.000). The use of steroids was a risk factor for SSI in patients undergoing colon surgery (OR=1.28, P=0.041). Laparoscopic surgery was a protective factor for SSI in 4 patients with gastrointestinal surgery (P<0.05).Conclusion Intraoperative blood transfusion, long operation time, and surgical incision type Ⅲ/Ⅳ were common risk factors for SSI in more than 3 types of gastrointestinal surgery. Laparoscopic surgery was a commonprotective factor for SSI. Risk factors such as the use of anti-diabetes and steroids vary in different types of surgery. |
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